Test 3 Flashcards
1
Q
Humalog (lispro)
A
- Rapid acting analog
- Insulin
- Onset: 10-30 minutes
- Peak: 30-90 minutes
- Duration: 3-6 hour
2
Q
Novolog (aspart)
A
- Rapid acting analog
- Insulin
- Onset: 10-30 minutes
- Peak: 30-90 minutes
- Duration: 3-6 hour
3
Q
Fiasp
A
- Rapid acting analog
- Insulin
- Onset: 10-30 minutes
- Peak: 30-90 minutes
- Duration: 3-6 hour
4
Q
Glulisine (apidra)
A
- Rapid acting analog
- Insulin
- Onset: 10-30 minutes
- Peak: 30-90 minutes
- Duration: 3-6 hour
5
Q
Human regular insulin
U-100 & U-500
A
- Short acting insulin
- Onset: 30-60 minutes
- Peak: 2-5 hours
- Duration: 5-8 hours
- Fewer and fewer providers are prescribing it due to its delayed onset
- Must inject before eating and wait to eat until the onset
6
Q
Human NPH
A
- Intermediate acting insulin
- Cloudy insulin
- Onset: 2-4 hours
- Peak: 4-12 hours
- Duration: 12-18 hours
- Always draw after regular insulin
- Used less and less due to delayed onset
7
Q
Glargine (Lantus)
A
- Long acting analog
- Insulin
- Onset: 1-2 hours
- Peak: Peakless
- Duration: 20-24 hours
8
Q
Detemir (Levemir)
A
- Long acting analog
- Insulin
- Onset: 1-2 hours
- Peak: 6-14 hours
- Duration: Up to 24 hours
9
Q
Degludec (Tresiba)
U-100 & U-200
A
- Ultra long acting insulin
- Onset: 30-90 minutes
- Peak: No peak
- Duration: >24 hours (42 hours)
- Can be injected at any time of day
- Can be mixed with other insulins (unlike most long-acting insulins)
10
Q
U300 Glargine (Toujeo/Sanofi)
A
- Ultra long acting insulin
- Smaller depot surface area means reduced rate of absoprtion and less discomfort when injecting
- 23 hour half life (steady state in 4 days)
- Duration: <36 hours
11
Q
Afrezza
A
- Inhaled insulin
- Onset: 12 minutes
- Peak: 35-45 minutes
- Duration: 15.-3 hours
- Only offered in 4, 8, and 12 unit doses, making it difficult to titrate
- Risk for bronchospasm (spirometry required prior to prescribing)
12
Q
Metformin (Glucophage/Riomet)
A
- Biguanide
- MOA Primary: Decrease glucose production in the liver via suppression of gluconeogenesis
- MOA Secondary: Enhanced glucose uptake and utilization in peripheral skeletal muscle
- Indications: 1st choice for obese patients, prevention of T2DM
- Advantages: No risk of hypoglycemia in monotherapy, weight loss, can be used in combo with insulin sensitizing drugs, can be used in kids
- Adverse effects: Abdominal cramping, nausea, decrease absorption of B12 and folic acid
- Contraindicated in patients with renal insufficiency (GFR <30ml/min)
13
Q
Glipizide (Glucatrol), glimeperide (amaryo), and glyburide (diabea/micronase)
A
- Insulin secretagogue
- Sulfonylurea
- MOA: Stimulates insulin secretion from pancreatic b cells
- 1st line of treatment for T2DM
- Given oral QD or BID with meals
- Adverse effects: Hypoglycemia, weight gain, GI disturbances
- Contraindicated in T1DM, pregnancy, and sever liver/kidney disease
14
Q
Repaglinide (Prandin)
A
- Insulin secretagogue
- Meglitinide
- MOA: Stimulates insulin secretion from pancreatic b cells (different site than sulfonylureas)
- Nursing considerations: Always give with a meal, peak effect in 1 hour
- Adverse effects: Hypoglycemia, possible weight gain
- Contraindications: T1DM, pregnancy, liver disease
15
Q
Nateglinide (Starlix)
A
- Insulin secretagogue
- Meglitinide
- MOA: Stimulates insulin secretion from pancreatic b cells (different site than sulfonylureas)
- Nursing considerations: Always give with a meal, peak effect in 1 hour
- Adverse effects: Hypoglycemia, possible weight gain
- Contraindications: T1DM, pregnancy, liver disease
16
Q
Rosigliazone (Avandia)
A
- Thiazolidinedione (TZD)
- MOA: Binds to nuclear receptor PPARy, a receptor that regulates the transcription of a gene involved in glucose producion, transport, and utilization
- Net effect: Cellular response to insulin is increased, improved insulin sensitivity in skeletal muscle (and adipose tissue and the liver), and reduced hepatic glucose production
- Adverse effects: Fluid retention (can lead to edema and HF), increased risk of fracture in women, hypoglycemia (when used with insulin), possible ovulation, increased risk of bladder cancer)
- Contraindications: Severe liver disease, DKA, T1DM, pregnancy, HF (block box warning)